World Malaria Report 2020

Published: 2 December 2020

ALMA commits to foster continental action to end Malaria amidst the COVID-19 fight as urgent action is needed

Through robust political commitments since 2000, African Heads of State and Government have provided leadership that has contributed to key gains against malaria. The World Malaria Report released by the WHO, Monday, indicates that malaria mortality declined by 67% since 2000 in Africa. This has resulted in 1.2 billion cases of malaria and 7 million deaths avoided. Nevertheless, malaria remains a significant threat to health and development. According to the WHO’s estimates, there were 215 million malaria cases and 384,000 malaria deaths in Africa in 2019 and malaria incidence has plateaued since 2015.  Africa is not on track to achieve its 2020 target of reducing malaria incidence and mortality by 40% and goal of eliminating malaria by 2030.

“In line with the Abuja Declarations and the bold and ambitious targets set in the Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030, and in the context of COVID-19 that has affected health systems across Africa, we need renewed commitment.  It is only through strong leadership  by the African Heads of State and Government and joint action through partners and communities that we can achieve the shared vision of malaria elimination in Africa” said Joy Phumaphi, ALMA’s Executive Secretary.

COVID-19 Response

The COVID-19 pandemic placed an incredible strain on health systems across Africa. At the beginning of the pandemic, WHO estimated malaria deaths in Africa could double to 769 000, if the planned insecticide-treated bed nets campaign did not take place and if access to case management was reduced by 75%. This would have represented a reversal in the substantial progress seen over the last two decades. To prevent this, WHO, the RBM Partnership to End Malaria, ALMA, and the AU emphasized ensuring the continuity of malaria prevention, testing and treatment whilst adhering to COVID-19 preventative guidelines and protocols. Likewise, the Global Fund allocated US$625 million to sustain malaria, TB and HIV programmes during the pandemic.

Countries responded with leadership:

  • 30 countries reorganised national indoor residual spraying and universal mosquito net campaigns, delivering approximately 180 million insecticide-treated nets door-to-door, while protecting workers and communities against the spread of COVID-19.
  • Workers were authorised to travel despite lockdowns so indoor residual spraying campaigns could be implemented.
  • More than 20 million children received seasonal malaria chemoprevention (a record).
  • Vulnerable and high-burden communities were prioritized.
  • Case management was sustained, and stock-outs avoided by air freighting medicines.
  • Existing resources were reprogrammed, and new resources were mobilised to procure Personal Protective Equipment for workers.
  • Advocacy and communications were intensified to ensure malaria remained high on the national agenda and that communities continued to seek care.
  • Case management was decentralised to the community level where possible.

Getting back on track

To reinvigorate progress, WHO and the RBM partnership to End Malaria catalysed the “high burden to high impact” (HBHI) approach in 2018. The response is led by 11 countries – including 10 in sub-Saharan Africa – that account for approximately 70% of the world’s malaria burden.

HBHI countries are moving away from a one-size-fits-all approach to malaria control – choosing instead to implement tailored responses based on local data and intelligence. This is coupled with enhanced political will, accountability, and resource mobilisation. While it is too early to evaluate the impact of this approach on malaria burden, important groundwork has been laid.

A recent analysis from Nigeria, for example, found that through an optimised mix of interventions the country could avert tens of millions of additional cases and thousands of additional deaths by the year 2023, compared with a business-as-usual approach. Nigeria has successfully secured U$300 million from the World Bank and Islamic Development Bank to fill key gaps under its national malaria strategy. Nigeria is also working on strategies to increase domestic financing for malaria.

The African Union launched the Africa wide Zero Malaria Starts With Me  Campaign for its 55 Member States in 2018 to reignite action to end malaria by 2030. 19 Countries have since launched  national campaigns with more expected in 2021.